Use of suPAR Algorithm for the ED Decision Making (EDsuPAR)

Helsinki University Central Hospital (HUCH)

Status: Completed

Conditions: Critical Illness

Treatments: Diagnostic Test: suPAR algoritm

Study type: Observational

Funder types: Other

Identifiers

NCT04402281

§33, HUS/141/2020 14.4.2020

Details and patient eligibility

About

Will the use of a clinical decision algorithm in the ED improve discharge or admission decisions.

Full description

Background Crowding and readmissions are common challenges in Emergency departments across Europe. The decision whether to admit or discharge the patient is challenging and is often based on clinical signs and symptoms e.g. blood pressure, pulse, respiratory rate, oxygen saturation and temperature. But some patients are unnecessarily admitted and may have been better off if sent home. Other patients may be discharged without - and one out of five patients are readmitted within a month raising the question whether the patient should have been admitted at first presentation in the ED. suPAR is a strong prognostic biomarker measured routinely in acute medical patients in some emergency department (ED) settings.suPAR is a broadly applicable biomarker of risk, and it has been developed an algorithm for simple interpretation of suPAR in clinical decisions for the study.

Objective To evaluate the use of a clinical decision algorithm in the ED with the aim of improving discharge or admission decisions.

Enrollment: 1,800 patients

Sex: All

Ages: 18 to 104 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All patients above 18 years
• who are having blood taken for biochemical analysis when attending the ED

Exclusion criteria

• Acute medical patients that do not have blood drawn for routine biochemical testing.
• Pregnant
• Under 18 years old
• Terminally ill patients.

Trial design

1,800 participants in 2 patient groups

suPAR algoritm control

Description:

Control arm (Meilahti hospital): Samples are collected and suPAR measured but no algorithm is implemented.

Treatment:

Diagnostic Test: suPAR algoritm

suPAR algoritm intervention

Description:

Intervention arm (Jorvi Hospital). According the algorithm when admitting a patient with suPAR below 3 ng/ml, physician should answer the following question "Are you sure it is the right decision to admit this patient? Please discuss this with a senior physician". If discharging a patient with suPAR above 6 ng/ml, physician should answer the following question "Are you sure it is the right decision to discharge this patient? Please discuss this with a senior physician".

Treatment:

Diagnostic Test: suPAR algoritm